Rapid improvements in pain and quality of life are sustained after surgery for spinal metastases in a large prospective cohort.
Publication/Presentation Date
6-1-2016
Abstract
Introduction Metastatic spinal cancer is a common condition that may lead to spinal instability, pain and paralysis. In the 1980s, surgery was discouraged because results showed worse neurological outcomes and pain compared with radiotherapy alone. However, with the advent of modern imaging and spinal stabilisation techniques, the role of surgery has regained centre stage, though few studies have assessed quality of life and functional outcomes after surgery. Objective We investigated whether surgery provides sustained improvement in quality of life and pain relief for patients with symptomatic spinal metastases by analysing the largest reported surgical series of patients with epidural spinal metastases. Methods A prospective cohort study of 922 consecutive patients with spinal metastases who underwent surgery, from the Global Spine Tumour Study Group database. Pre- and post-operative EQ-5D quality of life, visual analogue pain score, Karnofsky physical functioning score, complication rates and survival were recorded. Results Quality of life (EQ-5D), VAS pain score and Karnofsky physical functioning score improved rapidly after surgery and these improvements were sustained in those patients who survived up to 2 years after surgery. In specialised spine centres, the technical intra-operative complication rate of surgery was low, however almost a quarter of patients experienced post-operative systemic adverse events. Conclusion Surgical treatment for spinal metastases produces rapid pain relief, maintains ambulation and improves good quality of life. However, as a group, patients with cancer are vulnerable to post-operative systemic complications, hence the importance of appropriate patient selection.
Volume
30
Issue
3
First Page
337
Last Page
344
ISSN
1360-046X
Published In/Presented At
Choi, D., Fox, Z., Albert, T., Arts, M., Balabaud, L., Bunger, C., Buchowski, J. M., Coppes, M. H., Depreitere, B., Fehlings, M. G., Harrop, J., Kawahara, N., Martin-Benlloch, J. A., Massicotte, E. M., Mazel, C., Oner, F. C., Peul, W., Quraishi, N., Tokuhashi, Y., Tomita, K., … Crockard, H. A. (2016). Rapid improvements in pain and quality of life are sustained after surgery for spinal metastases in a large prospective cohort. British journal of neurosurgery, 30(3), 337–344. https://doi.org/10.3109/02688697.2015.1133802
Disciplines
Business Administration, Management, and Operations | Health and Medical Administration | Management Sciences and Quantitative Methods
PubMedID
26901574
Department(s)
Administration and Leadership
Document Type
Article